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This paper studies the interaction of the clinical theories of two major British theorists, Melanie Klein and Donald Winnicott. Through three clinical examples, we see how the >Klein-Winnicott dialectic< operates in a significantly developmental fashion to advance and fulfill clinical work. Winnicott’s >object survival< is looked at in developmental conjunction with Klein’s >mourning< as a primary clinical and developmental process. This interaction also captures the essence of working with the aggression of a self that has been traumatically disrupted within its early development. This paper demonstrates how such work leads to the assimilation and grieving of primal object loss, evolving into a >developmental mourning process.< This developmental mourning includes the working-through of an >abandonment depression< in the character-disordered patient. A clinical example in a 1989 essay on >psychic pain< by Betty Joseph is used to set up the clinical challenge of going beyond the symptomatic clinging behavior of developmental arrest, into full psychic birth as a separate other, an Other who can relate to an Other. Conclusively, the subjective visceral affect noted and monitored in its clinical dimensions here is that of human >heartache,< which can also include regret.